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Over 90% of babies are screened with the A-ABR at birth. This means most babies will need to be rescreened with ABR rather than OAE. View and download a copy of what type of screening equipment is used at all birthing facilities in Nebraska. This will help you know what type of rescreening a baby will need at your facility.

Audiologists Role in the Early Hearing Detection and Intervention Process

Audiologists determine whether a child is deaf or hard of hearing through screenings and diagnostic audiologic evaluations. Babies that do not pass their newborn hearing screening should have this evaluation
no later than three months of age. Habilitation, including amplification if chosen, and initiation of Early Intervention services should occur
no later than six months of age. These best practice guidelines are provided by the
Joint Committee on Infant Hearing (JCIH) in order to provide the best outcomes for children who are deaf or hard of hearing.

Best Practices

Complete initial diagnostic evaluation, by 1 month of age if possible, using a battery of physiological tests.

Report the results of diagnostic audiologic hearing evaluation to the child's primary care physician, including information that the infant was not successfully tested after being referred.

Reports the names of all children who received a diagnostic evaluation, and those who are not successfully tested after being referred for a diagnostic evaluation to the NE-EHDI Program.

Make a referral to the
Early Development Network (EDN) for children identified as deaf or hard of hearing, and report the date of referral to the NE-EHDI Program.

Provide parents with information about hearing and childhood deafness, and communication and education options for children who are deaf or hard of hearing.

Fit the child with amplification if chosen, including hearing aids or other assistive technology. Refer for consideration of cochlear implant candidacy when appropriate.

Appropriate intervention, whether amplification and/or sign language immersion is chosen by the family and should be started
by 6 months of age, if possible.

The approach to services should be family-centered by promoting family and professional partnerships, responding to needs, building on strengths and respecting the diversity of families.

The NE-EHDI Advisory Committee strongly recommends that any audiologist accepting infants younger that six months of age for audiologic assessment should follow best practice guidelines by having the ability to complete or refer to other pediatric audiology clinics with capability to perform the following procedures:

Auditory Brainstem Response (ABR)

Auditory Brainstem Response (ABR)

ABR threshold to frequency-specific stimuli for air and bone conduction.
ABR suprathreshold to click stimuli with varied rate and polarity.

* An
otologic evaluation is also part of the assessment process but it may occur at a different facility and time.

The Audiologist should discuss the results with the family and report the audiologic assessment results to the infant's Primary Health Care Provider and the Nebraska Early Hearing Detection and Intervention Program. If permanent deafness in one or both ears is identified, regardless of degree and type, families should be given the Nebraska Early Hearing Detection and Intervention Program's Parent Resource Guide.

In line with JCIH guidelines, audiologists seeing infants should adhere to the following protocols to ensure the child is receiving the most comprehensive care:

An infant who refers with an ABR
must be rescreened with an ABR screen

An infant who refers in only one ear should have both ears rescreened

These are evidence based guidelines that will help to identify most minimal deafness and auditory neuropathy cases present at birth.

Nebraska Hands and Voices is dedicated to supporting families with children who are deaf or hard of hearing without bias around communication modes or methods. They are a parent-driven, non-profit organization providing families with resources, networks, and information they need to improve communication access and educational outcomes for their children.

PTI Nebraska is a statewide resource for families of children with disabilities and special health care needs.

PTI Nebraska's staff are parent/professionals and are available to talk to parents and professionals about special education, other services and disability-specific information.